Healthcare Provider Details

I. General information

NPI: 1982584207
Provider Name (Legal Business Name): THOMAS PAOLINI
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/05/2025
Last Update Date: 06/09/2026
Certification Date: 06/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1860 S ORANGE GROVE AVE
LOS ANGELES CA
90019-5049
US

IV. Provider business mailing address

2201 S BEVERLY GLEN BLVD APT 104
LOS ANGELES CA
90064-2496
US

V. Phone/Fax

Practice location:
  • Phone: 323-297-3001
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code373H00000X
TaxonomyDay Training/Habilitation Specialist
License Number
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code225400000X
TaxonomyRehabilitation Practitioner
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: